Cognitive Disorders By Dr. Hayder AL-Hadrawi

PowerPoint PresentationStudents Learning Outcomes
At the end of this presentation, learners will be able to:
Describe the characteristics of and risk factors for cognitive disorders.
Distinguish between delirium and dementia in terms of symptoms and other
related issues.
Apply the nursing process to the care of clients with cognitive disorders.
Cognitive Disorder
Cognition is the brain’s ability to process, retain, and use information.
Cognitive abilities include:
many important tasks, including making
decisions, solving problems, interpreting
information.
Cognitive disorder is a disruption or impairment in these higher-level
functions of the brain.
Delirium
Dementia
effect on clients and family members or
caregivers.
Delirium Delirium is a syndrome that involves a disturbance of consciousness
accompanied by a change in cognition.
Characteristics of Delirium DSM-IV:
2) May have sensory disturbances such as illusions, misinterpretations, or
hallucinations.
4) Changes in psychomotor activity
5) emotional problems such as anxiety, fear,
irritability, euphoria, or apathy
dehydration, sleep deprivation, cardiovascular
to gasoline, paint solvents, insecticides, and
related substances
HIV, and syphilis.
Withdrawal: alcohol, sedatives, and hypnotics
Reactions to anesthesia, prescription medication, or illicit (street) drugs
Delirium Nursing Management:
disturbances in attention, cognition, psychomotor activity, level of consciousness,
and/or sleep–wake cycle.
Poor judgment
Cognitive impairment
Impaired memory
for decisions or actions if that is unsafe.
Client’s safety is a priority. The client may be
unable to determine harmful actions or
situations.
explain limits and reasons clearly, within the
client’s ability to understand.
The client has the right to be informed of any
restrictions and the reasons limits are needed.
Involve the client in making plans or
decisions as much as he or she is able to
participate.
client is emotionally invested.
or more often if needed .
Clients with organically based problems tend to
fluctuate frequently in terms of their capabilities.
Allow the client to make decisions as much
as he or she is able.
Decision making increases the client’s
participation, independence, and self-esteem.
including hygiene, activities, and so forth.
habitual activities do not require decisions
about whether or not to perform a particular task.
Delirium Nursing Management:
Poor judgment
Cognitive impairment
Impaired memory
on misperceptions, délusions, or
the client feels validated for his or her feelings.
Teach the client about underlying cause(s)
of confusion and delirium.
Expected Outcomes
staff and caregiver
3. Increase reality contact
4. Cooperate with treatment
activities of daily living.
2. Demonstrate decreased confusion,
confusion
caregiver before taking action
Dementia Dementia is a mental disorder that involves multiple cognitive deficits,
primarily memory impairment, and at least one of the following cognitive
disturbances:
Dementia
Mild dementia: The client has difficulty finding words, frequently loses
objects, and begins to experience anxiety about these losses.
Moderate dementia: Confusion with progressive memory loss. (The person no
longer can perform complex tasks but remains oriented to person and place).
Severe dementia: Personality and emotional changes occur. The person may be
delusional, wander at night, forget the names of his or her spouse and children,
and require assistance in activities of daily living
Dementia Etiology of Dementia:
Genetic component, such as Huntington’s disease
Abnormality of apolipoprotein E gene (APOE), such as in Alzheimer’s disease.
APOE provides instructions for making a protein.
Infections such as human immunodeficiency virus (HIV) infection or
Creutzfeldt–Jakob disease.
Dementia Nursing Management:
information or behavioral skills.
Inability to recall factual
basis or in a small group.
Reminiscence is usually an enjoyable
activity for the client.
reminders
appointments, activities, and so on from memory.
Minimize environmental changes and
There is less demand on memory function when
daily routine is met.
client when instructions are needed.
Clients with memory impairment cannot
remember multistep instructions.
implements. “Here is a spoon you can
use to eat your lunch.”
The client may not remember what an implement
is for
independently.
Dementia Nursing Management:
Inability to recall
factual information or
time.
and minimize his or her frustration
Expected Outcomes
a) The client will be free of injury.
b) The client will maintain an adequate balance of activity and rest, nutrition, hydration, and
elimination.
c) The client will function as independently as possible given his or her limitations.
d) The client will feel respected and supported.
e) The client will remain involved in his or her surroundings.
f) The client will interact with others in the environment
Amnestic Disorder
Amnestic Disorder:
Disturbance in memory that results directly from the physiologic effects of a
general medical condition or the persisting effects of a substance such as
alcohol or other drugs.
Memory disturbance is sufficiently severe to cause marked impairment in
social or occupational functioning.
Disturbance in memory results from stroke or other cerebrovascular events,
head injuries, chronic alcohol ingestion, and Korsakoff’s syndrome or thiamine
deficiency (Vitamin B12).
Amnestic Disorder
Nursing Management:
Nursing diagnoses and interventions are similar to those used when dealing with
the memory loss, confusion, and impaired attention abilities of clients with
dementia and delirium.